Posterior fossa dermoid: yet another cause of difficult airway?

Klippel-Feil syndrome and craniovertebral junction anomalies are known to pose challenges while the airway is being secured. These anomalies may occur in association with dermoid and epidermoid cysts in the posterior fossa. We present a case of posterior fossa dermoid with extracranial extension that caused severely restricted neck movement. As these anomalies seem to form part of a single, unnamed syndrome, the possibility of upper cervical spine abnormality leading to a difficult airway should be anticipated in patients with posterior fossa dermoid.